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Treating Older Adults' Depression Eases Family Caregiver Burden

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Caring for an older loved one can be challenging, even burdensome, particularly if he or she is depressed. Caregivers who care for older adults who are depressed are more burdened and have poorer mental and physical health than those who care for elders who are not depressed, research shows.

Fortunately, late-life depression can be treated with antidepressant drugs. In addition to boosting depressed older adults' moods and improving their quality of life, these drugs can lower their risks of disability.

New Research in the Journal of the American Geriatrics SocietyTo learn more about how treating depression in older adults affects their caregivers, researchers studied nearly 250 seniors diagnosed with major (or serious) depression and those caring for them.

At the start of the study, the researchers tested each caregiver to determine how heavy his or her overall caregiver burden (or "general caregiver burden") was, and how heavy the burden related to their loved one's depression (or "depression-specific burden") was. The researchers found that the caregivers had moderate to high burden.

For the next six weeks, all of the older adults in the study took a low dose of an antidepressant drug and got "depression care management" -- treatment designed to improve care for those with depression. After those six weeks, the researchers reevaluated the seniors to determine whether and to what extent they were depressed. The researchers also retested the seniors' caregivers, measuring their general caregiver burden and depression-specific burden once again.

Many of the older adults who took the low-dose antidepressant were significantly less depressed after the six weeks of drug therapy, the researchers found. And their caregivers experienced a significant decrease in depression-specific burden, as well as lower general caregiver burden.

Some of the older adults in the study, however, didn't respond as well to the low-dose antidepressant and were still quite depressed after the six weeks. So the researchers divided these seniors into two groups. One group got a higher dose of the drug for another 16 weeks. The other group got both a higher-dose of the medication and "interpersonal psychotherapy" aimed at treating depression, for an additional 16 weeks. After the 16 weeks, the researchers again tested the older adults to find out how depressed they were. The researchers also measured the caregiver burden and depression-specific burden of these seniors' caregivers.

About half of these seniors got significant relief from depression when given the higher-dose drug alone or the higher dose and the therapy, the researchers found. (It's possible that getting the therapy in addition to the higher-dose drug didn't seem to increase the likelihood of improvement because all of the older adults in the study got depression care management, which resembled the therapy in some ways, according to the researchers.) The caregivers of the adults who got relief from depression with the higher-dose drug -- either with our without the therapy -- also benefited, the researchers found. Their levels of depression-specific burden dropped significantly.

"Treatment of late-life depression has benefits that extend to the family members on whom patients depend," the researchers report in the January 2010 issue of the Journal of the American Geriatrics Society.

The summary above is from the full report titled, "Treatment of Late-Life Depression Alleviates Caregiver Burden." It is in the January 2010 issue of the Journal of the American Geriatrics Society (Volume 58, Issue 1). The report is authored by Lynn M. Martire, PhD, Richard Schulz, PhD, Charles F. Reynolds III, MD, Jordan F. Karp, MD, Ariel G. Gildengers, MD, and Ellen M. Whyte, MD